President Donald Trump’s attack on his own health experts’ guidance for safely reopening schools cracked open for public display a power struggle within the administration that has been building for months.
Trump blasted the guidance issued by the Centers for Disease Control and Prevention on Wednesday as “very tough & expensive” and “asking schools to do very impractical things.”
But CDC Director Dr. Robert Redfield said on Thursday the guidance would stand, and his staff would provide some new documents to clarify the recommendations.
Wednesday’s flare-up punctuates a conflict escalating for months, with the nation’s top scientists publicly sidelined in the Trump administration’s initial coronavirus response. Earlier disagreements delayed the release of the reopening guidance for schools and businesses.
Public health leaders who worked at the CDC under prior presidents said they had never seen anything like this week’s open discord. Those signals can impair the guidance and the White House coronavirus task force itself, the experts said.
"It undermines leadership for everyone involved,” said Dr. Jeffrey Koplan, vice president for global health at Emory University and a former CDC director, who bristled at the idea that expense should drive school decisions. "I don’t remember hearing that for the airports and bars.”
"It's public health malpractice to say, 'Open without worrying about anything,’" he said.
The CDC’s current recommendations, which urge America’s frequently overcrowded classrooms to put six feet of distance between every student desk, have seen increasing scrutiny as communities grapple with how to safely resume classes as early as next month.
The nation’s pediatricians, for example, recently called out the CDC’s six-foot guidance. It said such stringent distancing could do more harm than good by forcing schools to reduce classroom capacity.
The start of a new school year comes as many states, especially in the Sunbelt region, confront a surge in coronavirus cases after reopening everything from restaurants to day camps. The Trump administration’s loose guidance gave states and localities wide leeway on how to end a nationwide shutdown during the early weeks of the pandemic.
The school question is particularly fraught. Children have not been sickened by the new coronavirus as adults, yet spreading it remains a concern with reopening schools. The nation’s experiment with virtual education in the spring was widely panned as a failure, showcasing inequities in the nation's digital divide and asking many parents to serve as their children’s teachers while also juggling their work.
Vice President Mike Pence, who leads the White House coronavirus task force, said on Thursday new documents would be issued next week supplementing the original guidelines. He had previously cited those same plans at a press conference earlier in the week.
The White House did not respond to questions seeking clarity about how the supplemental documents, which have not yet been released, might impact the previous recommendations. The CDC pointed to Redfield’s comments in an interview with ABC on Thursday that the agency would “provide additional information to help the schools be able to use the guidance that we put forward.”
Devin O’Malley, press secretary for Pence, declined to comment on how these guidelines, which the White House has now labeled inadequate, passed through the task force’s review process.
“This week the administration and task force have elevated the conversation around reopening schools to the national level,” O’Malley said, pointing to the federal government’s role in helping local communities safely reopen schools.
The CDC’s school reopening guidelines, first published in May, were part of a larger battery of recommendations for reopening the country safely that had previously received scrutiny and approval from the task force. Administration officials had labeled earlier versions "overly prescriptive" after reports that they shelved guidance.
USA TODAY has reported multiple instances since February in which CDC officials, at odds with the White House, felt pressured to bend public health guidance or ignore scientific evidence.
Recently, the administration has explored blaming Latinos for regional spikes in new coronavirus cases. The White House also has pushed for a return to the failed strategy of relying on temperature screenings to detect coronavirus infections in airlines passengers, despite the strong objections of CDC scientists.
“Hyper-politicized messaging makes it hard to adapt to and use the science-driven information,” said Alonzo Plough, a longtime former public health director in major U.S. cities, now the chief science officer and vice president of the Robert Wood Johnson Foundation. He also serves as an independent scientific advisor to the CDC’s Center for Preparedness and Response. “It costs us in terms of increasing case counts and mortality.”
The politicized role of the CDC in the coronavirus pandemic prompted nearly 350 public health organizations to sign a letter last week asking Health and Human Services Secretary Alex Azar to affirm the agency’s role in providing evidence-based scientific guidance.
“It is a scientific organization that functions best as an apolitical agency trusted to guide the strategy of our nation to be healthier and safer,” noted the letter, signed by groups representing the nation’s pediatricians and state health officers. “We must amplify the unfettered voice of CDC, not stifle it.”
Nancy Cox, the CDC's former director of the influenza division who worked at the agency for almost 30 years, said the public pushback from the administration is self-defeating because the guidelines currently in place are in line with those of European countries that successfully reopened schools.
"I'm just speechless,” Cox said of Trump’s criticism via Twitter. She noted that such disagreements usually occur out of public view to avoid confusing people. "I've never seen anything quite like what happened yesterday.”
The school guidance has been a touch point for Trump, who wants to bring students back to campuses. Public health experts are also increasingly concerned about the toll on children’s well-being, with many depending on schools to provide everything from nutritious meals to safeguards against abuse.
But with the start of the school year weeks away, the U.S. lacks a blueprint for a safe return.
The nation’s largest school system in New York City on Wednesday announced plans to limit classroom instruction to one to three days per week in the fall, staggering schedules to reduce classroom crowding.
Florida Governor Ron DeSantis, a Trump ally, wants to see instruction five days per week, which his education department required this week via an emergency order. Localities are still weighing their options as the state sees a surge in coronavirus cases.
The CDC’s reopening guidance does not envision a normal school year for America’s campuses, and presents logistical challenges for the nation’s school districts, which range widely in the size and diversity of their student populations and the funding available to serve them.
It encouraged schools to space desks out by six feet – the recommended distance for physical distancing in many settings to limit the spread of the COVID-19 virus – and suggested that school buses when possible run with empty rows between students.
The American Academy of Pediatrics recently issued guidelines offering an alternative to the CDC’s distancing recommendations. It highlighted more recent evidence suggesting that three feet of distance between desks could be adequate, especially when coupled with face masks.
If elementary schools strictly impose six-foot distancing, it noted, the “harm may outweigh potential benefits.”
Dr. Nathaniel Beers, a pediatrician who helped to develop the AAP’s guidance, explained that the CDC’s strict distancing recommendations could reduce the number of students attending class by 50 percent, forcing shorter or fewer instructional days.
“That has huge ramifications,” he said. “Our goal was to make sure that we were encouraging a robust conversation at the local level about what was possible and what the decisions meant.”
State officials relying on the CDC to sift through the science on how to reopen schools are now left waiting for the updated recommendations.
"We have seen what happens when you reopen states' economies too quickly," said Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials, noting public health experts share the president’s desire to resume classroom instruction safely. “We don’t want to reopen school and they have another setback and disaster.”
Additional reporting by USA TODAY reporters Courtney Subramanian, Karen Weintraub and Marco della Cava.
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